Predictors and Complications of Blood Transfusion in Total Hip and Knee Arthroplasty

Frisch, Nicholas B.; Wessell, Nolan M.; Charters, Michael A.; Yu, Stephen; Jeffries, James J.; Silverton, Craig D.

doi:10.1016/j.arth.2014.03.048

Cited by 163 publications

(158 citation statements)

References 19 publications

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“…This finding also agrees with the described recent multicentre study showing a substantial reduction in transfusion rates for this technique when compared to the national average in the United States [4]. Transfusions have been associated with increased complications, such as infections [8,9]. This suggests that the reduction in transfusions seen in the SuperPath group may have the potential to decrease not only in-hospital costs but also those associated with treating complications related to transfusions.…”

Section: Discussionsupporting

confidence: 81%

In-hospital cost comparison between the standard lateral and supercapsular percutaneously-assisted total hip surgical techniques for total hip replacement

Gofton

Fitch²

2015

International Orthopaedics (SICOT)

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Section: Discussionsupporting

confidence: 81%

In-hospital cost comparison between the standard lateral and supercapsular percutaneously-assisted total hip surgical techniques for total hip replacement

Gofton

Fitch²

2015

International Orthopaedics (SICOT)

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“…Numerous studies reported high postoperative blood losses after TKA implantation (6,13,14). As shown by our study, the difference in the incidence of bleeding complications in patients after THA compared to that after TKA was not signifi cant.…”

Section: Discussionsupporting

confidence: 51%

THA and TKA in patients with cardiovascular disease: What makes the risk of perioperative bleeding?

Džupa¹,

Motovska²,

Widimský³

et al. 2017

BLL

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BACKROUND: The purpose of the study was to ascertain the incidence of bleeding and ischaemic complications in patients with cardiac disease after total hip arthroplasty (THA) and total knee arthroplasty (TKA). METHODS: In total, 477 patients (289 women, 188 men) with known history of cardiac disease or thromboembolic disease treated with surgery in 2010-2013, were enrolled in the study. Perioperative prevention of thromboembolic disease using low-molecular-weight heparins was applied in all the patients. The data that could have an impact on the development of monitored perioperative complications, were observed. RESULTS: Complications occurred in 55 (11.6 %) patients: bleeding complications in 32, ischaemic in 19, and both in four patients. Complications were found in 13 (12.0 %) patients after THA and in 6 (9.5 %) patients after TKA. Bleeding complications were observed in 17 patients after THA and TKA, ischaemic in one, and both simultaneously in one patient. Bleeding complications occurred insignifi cantly more frequently after THA and TKA (p = 0.094); however, this difference was statistically signifi cant after adjustment for risk factors (p = 0.003). On the contrary, ischaemic complications were signifi cantly more frequent after other skeletal surgeries (p = 0.014). Nevertheless, this difference was not statistically signifi cant after the adjustment (p = 0.880). The comparison of the risk of complications in patients after THA with that in patients after TKA showed no signifi cant difference (p = 0.580). CONCLUSION: The study showed a signifi cantly higher incidence of bleeding complications in patients after THA and TKA compared to other surgeries of the musculoskeletal system in patients with a history of cardiac disease. Bleeding complications cannot be detected in advance (Tab. 1, Ref. 16). Text in PDF www.elis.sk.

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“…Minimizing transfusions is another key factor that could decrease the economic burden of THA, as Tuttle et al estimated the cost of each transfusion to be $787.37 at their institution [13]. In addition to directly adding cost, transfusions have also been linked to increased incidence of complications, including deep surgical site infections [5]. Therefore by minimizing transfusions, there is also the potential to reduce other complications that could result in readmissions.…”

Section: Other Outcomes Of Interestmentioning

confidence: 99%

“…In the present study, there were no instances of infection or sepsis and only a single thromboembolic event (0.2 %). The lack of these complications could be due to several features of the SuperPath technique including: a reduced need for soft tissue dissection with electrocautery; a lack of need to cut muscles or tendons; and the reduced need for transfusions, which have been previously linked to an increased incidence of surgical site infections [5]. The dislocation rate (0.8 %) was also decreased from those reported in some recent THA studies (2.9-6.0 %) and could help to further explain the reduced readmission rate [6][7][8].…”

Section: Thirty-day Readmission Ratementioning

confidence: 99%

Thirty-day readmission rate and discharge status following total hip arthroplasty using the supercapsular percutaneously-assisted total hip surgical technique

Gofton

Chow

Olsen

et al. 2014

International Orthopaedics (SICOT)

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Purpose Recent studies have reported nearly 40 % of costs associated with a 30-day episode-of-care for total joint replacements are due to post-discharge activities and 81 % of those are specifically due to unplanned readmissions and discharging patients to post-acute care facilities. The purpose of this study was to determine these two key variables for total hip arthroplasty (THA) patients implanted using a tissuesparing surgical technique and to see how these values compare to those previously reported in the United States. Methods The healthcare databases at three institutions were searched for primary THA patients implanted using the supercapsular percutaneously-assisted total hip (SuperPath) surgical technique between January 2013 and July 2014. Data elements included 30-day all-cause readmission rate, discharge status, transfusion rate, complications, and length of stay (LOS). Results Data were available for 479 THAs. The 30-day allcause readmission rate, transfusion rate, and average LOS was 2.3, 3.3 %, and 1.6 days, respectively. Over 91 % of patients were discharged routinely home, 4.1 % to skilled nursing facilities, 3.8 % to home health care, and 0.6 % to inpatient rehabilitation facilities. Complications included dislocation (0.8 %), periprosthetic fracture (0.8 %), and deep vein thrombosis (0.2 %). There were no infections reported. Conclusions Patients implanted using this tissue-sparing technique experienced reduced 30-day all-cause readmission rates (2.3 % vs. 4.2 %) and more were routinely discharged home (91.5 % vs. 27.3 %) than have been previously reported for patients in the United States. Use of this tissue-sparing technique has the potential to significantly reduce post-discharge costs.

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Predictors and Complications of Blood Transfusion in Total Hip and Knee Arthroplasty

Cited by 163 publications

References 19 publications

In-hospital cost comparison between the standard lateral and supercapsular percutaneously-assisted total hip surgical techniques for total hip replacement

In-hospital cost comparison between the standard lateral and supercapsular percutaneously-assisted total hip surgical techniques for total hip replacement

THA and TKA in patients with cardiovascular disease: What makes the risk of perioperative bleeding?

Thirty-day readmission rate and discharge status following total hip arthroplasty using the supercapsular percutaneously-assisted total hip surgical technique

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